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55ESPE Poster presented at: Novel Uses of Psychiatric Drugs to Treat Hypothalamic Obesity MC. Azcona, F.J. Aguilar, J.L. León, A. Ochotorena, A. Navedo, A. Catalán, P. Sierrasesúmaga, M. Prados, E. Arnaus. Endocrinology Unit. Dpt. of Paediatrics. Faculty of Medicine. Clínica Universidad de Navarra. Pamplona and Madrid. Spain. Results Introduction and Objectives • Hypothalamic Obesity (HO): secondary to hypothalamic damage. Multifactorial etiology: tumors, syndromes, infections… • Main Clinical Features: - Hyperphagia and loss of satiety feeling. - No response to dietetic measures, medical therapy or even surgery. - Treatment: personalised due to its wide etiology. Hypotalamic damage makes difficult the response to conventional medical therapies. • Objectives: - To describe the natural history of the disease in patients who attended to our centre from childhood to adolescence. - To find new uses of psychiatric drugs that might shed new light in the treatment of HO. Methods • Medical records review: 10 patients diagnosed with HO and treated by a multidisciplinary team at the paediatric Endocrinology Unit, from January 1990 to December 2015. • Data collected: anthropometry weight (kg), height (cm) and BMI (Kg/m 2 ), clinical data and treatment received to manage weight gain. • Anthropometric reference data: Carrascosa et al, 2008. • Some drugs required compasive use, and were approved by the Hospital Ethics Committee and Ministry of Health. Pilocytic Astrocytoma Pilocytic Astrocytoma Neonatal Meningitis Hypothalamic Neurocytoma Anaplastic fibrillary Astrocytoma Craneofaringioma Prader-Willy (n=4) Age/sex at diagnosis 12.5 / M 12 / M 1.5 / F 2.9 / F 12 / F 12 / F 6.4 / 1M , 3F Weight-SDS at diagnosis -0.2 +3,1 +3.5 +7.1 -1.6 -0.48 +5.8 Weight-SDS after treatment +0.1 +3 +8.7 +7.1 -0.3 +1.9 +4 BMI-SDS before HO therapy +1.1 +4.19 +5.7 +6.4 -1.3 -0.19 +6.4 BMI-SDS after HO therapy +1.8 +5 +9.7 +8.2 +0.3 +2.5 2.9 BMI gain 12 48 33 12 11 14 18 BMI decrease No 2 6.5 2.8 No 0.6 2.5 Hormonal therapy Hydrocortisone L-thyroxine GH Desmopressin Hydrocortisone L-thyroxine Desmopressin L-thyroxine Desmopressin Hydrocortisone L-thyroxine GH Desmopressin None Hydrocortisone L-thyroxine GH Desmopressin GH Estrogens Other therapies Dextroamphetamine Sibutramine Surgery Methylphenidate Surgery Metylphenidate Topiramate Antiibioics Dextroamphetamine Surgery Methylphenidate RT, QT Surgery Melatonine Surgery, RT Risperidone Sertraline Bariatric Surgery Conclusions • Patients with HO gain weight rapidly one year after diagnosis or tumor therapy. • HO should be assessed and treated early at the diagnosis. • Some psychiatric drugs such as mehtylphenidate and dextroamphetamine might be useful and improve quality of life. Pituitary and Neuroendocrinology. P2-769 Height Weight 1. Bereket a, Kiess W, Lustig RH, Muller HL, Goldstone a P, Weiss R, et al. Hypothalamic obesity in children. Obes Rev. 2012 Sep;13(9):780–98. 2. Kim JH, Choi J-H. Pathophysiology and clinical characteristics of hypothalamic obesity in children and adolescents. Ann Pediatr Endocrinol Metab. 2013;18(4):161–7. Bibliography 769--P2 Maria Cristina DOI: 10.3252/pso.eu.55ESPE.2016 Pituitary and Neuroendocrinology
